经皮微创内外侧解剖锁定板在胫骨远端骨折中的应用

目的]探讨经皮微创内外侧解剖锁定板固定治疗胫骨远端骨折的手术时机、手术优势和手术要求。方法]选取43例胫骨远端骨折先行跟骨牵引,二期行经皮微创内或外侧解剖锁定板内固定为治疗组,随机选取同时期切开复位内或外侧解剖锁定板内固定为对照组,分析两组手术时间、术中出血量、住院时间及术后并发症,术后疗效按Tornetta判断标准进行比较。结果]两组在手术时间、住院时间、术中出血量及骨折愈合时间、远期功能疗效满意度方面差异均有显著性统计学意义。结论]经皮微创与切开复位内或外侧解剖锁定板治疗胫骨远端骨折均取得满意的术后疗效,但采用经皮微创闭合复位的方法治疗胫骨远端骨折创伤小、大幅减少医源性软组织损伤和骨血运破坏,减少伤口严重并发症的发生,有利于骨折愈合,有利于早期功能康复。

Clinical application of percutaneous minimally invasive locking compression plate on distal tibial fractures

Objective]To explore the operation timing,superiority and requirement of the minimally invasive locking compression plate in treating distal tibial fracture.Method]From August 2007 to April 2011,forty-three distal tibial fracture patients were treated with skeletal traction of calcaneus before operation.When limbs swelling disappeared,they were treated with percutaneous minimally invasive locking compression plate(LCP)from interior or lateral way.The results of operation period,hemorrhage quantitative,fracture healing period and long term effect were compared with 43 cases at the same time treated with plate(control group).Result]All cases were followed up(above 1 year).Long term effect was evaluated by Tornetta evaluation standard.The difference of the above index of the two groups was significant(P<0.05).Conclusion]The minimally invasive LCP represents a superiority in treating the distal tibial fractures,with advantage of protecting parenchyma and periosteum of the fractures site,decreasing the damage of the blood circulation of bone,decreasing wound severity complications,facilitating fractures healing and facilitating early functional rehabilitation.